These are notices that Blue Cross Blue Shield of Michigan makes available to PPO and traditional members and providers. These notices describe our relationships with our members and providers.
Blue Cross Blue Shield of Michigan and your primary care physician are interested in your satisfaction with the services you receive as a member. If you have a problem or concern about your care, we encourage you to discuss this with your primary care physician first. Often your primary care physician can correct the problem to your satisfaction. You are always welcome to call our customer service department with any questions or problems you may have.
At any point during the complaint process, you may submit any information or evidence concerning the complaint to assist Blue Cross in our investigation. You may file a complaint or appeal verbally or in writing. Complaints will not be accepted through email. There are no fees or costs associated with filing a complaint. All complaints can be submitted through customer service or via mail to the address listed below.
Customer service: Use the phone number on the back of your Blue Cross Blue Shield of Michigan member ID card.
BCBSM Complaints — Mail Code CS3A
Blue Cross Blue Shield of Michigan
600 E. Lafayette Blvd.
Detroit, MI 48226
At Blue Cross Blue Shield of Michigan, we've always followed strict internal procedures to protect the confidentiality of your health information. We value your membership, and we take our responsibility to protect the privacy and security of your health information very seriously.
Our Notice of Privacy Practices (PDF) outlines how we will use and disclose your data while it's in our care. We're permitted to use and disclose your protected health information only as specified in our notice.
You may also call the customer service number on the back of your member ID card to request a copy of the notice.
Some employer groups must provide their own notices. You should check with your employer to determine how you can get a copy of the notice.
Utilization management decision-making is based only on appropriateness of care and service and existence of coverage.
Blue Cross Blue Shield of Michigan does not specifically reward practitioners or other individuals for issuing denials of coverage.
Financial incentives for utilization management decision-makers do not encourage decisions that result in underutilization.
The Medical Policy Administration of Blue Cross Blue Shield of Michigan and the Care Management department of Blue Care Network of Michigan are responsible for the evaluation of new technologies and the new applications of existing technologies, the development of medical policies related to these technologies and the development of coverage recommendations. This process includes, but is not limited to, the following areas for potential new technologies: medical procedures and services, medical devices, surgical procedures, behavioral health procedures and pharmaceuticals.
Blue Cross Blue Shield of Michigan conducts quality initiatives to improve health care for our members.
The BlueCard program allows our members and their dependents to receive covered inpatient hospital care and physician services when traveling inside the United States but outside the area of their plan’s coverage. Read the official disclosure statement (PDF) of the BlueCard and the Blue Cross Blue Shield Global Core programs for the Blue Care Network HMO plan. Refer to your Certificate of Coverage and riders or call customer service to find out about limitations to travel coverage.
Blue Cross Blue Shield Global Core allows our members to find doctors, hospitals and resources outside of the U.S., Puerto Rico and the U.S. Virgin Islands. Register on the website or through the mobile app to find medication, file a claim or translate medical terms while you're traveling outside of the U.S.
Privacy issues: To report a concern or if you think your protected health information has been compromised, please call us at 1-800-552-8278 or email us. Don't include any protected health information in your email.
Other issues: For customer service, call the number on the back of your member ID card.